Lymphoepithelial cyst of the pancreas. No evidence for Epstein-Barr virus-related pathogenesis.

R E Schwarz, L M Weiss
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Abstract

Compared to pseudocyst formation after prior pancreatitis, true cysts of the pancreas are rare. Pancreatic cysts with irregular wall components or a mucinous content raise the suspicion for the presence of a cystic neoplasm, and surgical resection is recommended. A case of a patient with a history of prostate cancer is described in whom a cyst of the pancreatic tail was discovered incidentally. Based on the radiographic features, which did not support the presence of a serous cystadenoma, a spleen-preserving distal pancreatectomy was performed. Histologic features were characteristic for a lymphoepithelial cyst (LEC) of the pancreas, lined with thinned squamous epithelium surrounded by benign lymphoid tissue. Since LECs of the parotid gland, which are associated with acquired human immunodeficiency, are frequently related to Epstein-Barr virus (EBV) infection, EBV in situ hybridization was performed and did not reveal evidence for EBV. Twenty-eight instances of pancreatic LECs have been reported, primarily affecting adult males, without evidence of increased numbers of EBV-positive cells. The pathogenesis, differential diagnosis, and clinical implications of lymphoepithelial pancreatic cysts are discussed.

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胰腺淋巴上皮囊肿。没有证据表明与eb病毒相关的发病机制。
与先前胰腺炎后的假性囊肿形成相比,真正的胰腺囊肿是罕见的。胰腺囊肿伴有不规则的壁成分或粘液内容物,可引起囊性肿瘤的怀疑,建议手术切除。一个病例的病人与前列腺癌的历史是描述在一个囊肿的胰腺尾部偶然发现。基于不支持浆液性囊腺瘤存在的影像学特征,我们行保留脾脏的远端胰腺切除术。胰腺淋巴上皮囊肿(LEC)的组织学特征是薄的鳞状上皮被良性淋巴组织包围。由于与获得性人类免疫缺陷相关的腮腺LECs经常与eb病毒(EBV)感染有关,因此进行了EBV原位杂交,并未发现EBV的证据。已经报道了28例胰腺LECs,主要影响成年男性,没有证据表明ebv阳性细胞数量增加。本文讨论了淋巴上皮性胰腺囊肿的发病机制、鉴别诊断和临床意义。
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